The key to avoiding cold weather injuries is to dress appropriately. This includes layering clothing with a first layer that pulls moisture away from the skin, an outer layer that keeps the elements out and a middle layer that insulates. Hats are a must because the head is where 30 percent of the bodyís heat loss takes place. Gloves and face protection also are necessary in extremely cold weather.

What is frostbite?

Frostbite is caused by exposure to dry, cold temperatures below freezing. It can result in permanent damage and tissue loss. The most susceptible body parts are fingers, toes, cheeks, ear lobes and the tip of the nose because they are located at the most distant points of the circulatory system. A precursor to frostbite is frostnip, in which the skin is numb, white and firm to the touch.

What are the risk factors for frostbite?

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Inadequate or poorly fitted clothing, exposure to wind, dampness, contact with cold objects, dehydration, shock and trauma, hardening of the arteries, smoking, a history of frostbite, alcohol and other substance abuse, and fatigue.

What are the symptoms of frostbite?

Early symptoms of frostbite include tingling, numbness and pain in the affected area. The skin turns white or gray, and is cold and hard to the touch. There is no feeling in the affected area. The skin may blacken and form a tough layer that eventually disappears, revealing new skin that will always be more susceptible to frostbite. Deep frostbite can involve underlying tissue, muscle, tendon and bone.

How do I treat frostbite?

Seek medical attention immediately. If transportation is delayed, rewarm the affected area in warm bath water. If a thermometer is not available, the water should feel comfortably warm to unaffected parts. Give the person warm, non-alcoholic fluids. Rewarming at the location should be avoided if medical

care is available within 2 hours.

During rewarming, the affected area will become extremely painful, red and blotchy, indicating return of adequate circulation. Wash the area thoroughly with soap and water. When color returns, wrap the part in sterile gauze or a clean cloth, separating the fingers and toes. Elevate the affected part after rewarming to decrease swelling and pain.

What is hypothermia?

Hypothermia occurs when the bodyís core temperature falls below 95 F. This happens through exposure to cool and/or damp conditions. Cardiac arrhythmia also is possible when the core body temperature falls below 95 F. The elderly, immobile and psychiatric patients are most at risk. Often times, hypothermia affects elderly people who live in poorly heated homes.

Seek medical attention immediately. In mild hypothermia, give the person warm, non-alcoholic fluids and cover his or her head. When hypothermia is more severe, treatment varies based on age. A young person can be warmed in a hot bath (115 F). However, this can be fatal for elderly people. Warming should be gradual with the elderly, at about 1 degree per hour. Make sure clothing is dry and wrap the person in blankets. Hypothermia patients generally have a good prognosis unless they go into cardiac arrest or complications arise from an associated illness.